<!DOCTYPE html>
<html>
<meta charset="utf-8">
<head th:include="include::header"></head>
<body class="gray-bg">
<div class="wrapper wrapper-content animated fadeInRight">
	<div class="row">
		<div class="col-sm-12">
			<div class="ibox float-e-margins">
				<div class="ibox-content">
					<form class="form-horizontal m-t" id="signupForm">
						<div class="form-group">
							<label class="col-sm-3 control-label">提现金额：</label>
							<div class="col-sm-8">
								<input id="cashAmount" name="cashAmount" class="form-control" type="text">
							</div>
						</div>
						<div class="form-group">
							<label class="col-sm-3 control-label">提现方式：</label>
							<div class="col-sm-8">
								<select data-placeholder="提现方式" name="payWay"
										class="form-control chosen-select" tabindex="2" style="width: 100%">
									<option value="1">支付宝</option>
									<option value="2">微信</option>
									<option value="3">QQ钱包</option>
									<option value="4">银行卡</option>
								</select>
							</div>
						</div>
						<div class="form-group">
							<label class="col-sm-3 control-label">备注：</label>
							<div class="col-sm-8">
								<input id="remark" name="remark" class="form-control" type="textarea">
							</div>
						</div>
						<div class="form-group">
							<div class="col-sm-8 col-sm-offset-3">
								<button type="submit" class="btn btn-primary">提交</button>
							</div>
						</div>
					</form>
				</div>
			</div>
		</div>
	</div>
</div>
<div th:include="include::footer"></div>

<script type="text/javascript" src="/js/appjs/sys/statis/cash.js"></script>
<script type="text/javascript" src="/js/appjs/sys/check/cursor.js"></script>
</body>

</html>
